MORE VIDEOS
Explore more

Radiofrequency denervation (RFA) for facet joint pain

Category: Minor Procedures, Injections & Pain Relief · All minor procedures, injections & pain relief

Radiofrequency denervation (RFA) for facet joint pain — Minor Procedures, Injections & Pain Relief

What it is

Radiofrequency denervation uses heat from a needle electrode to temporarily disable the small nerves (medial branches) that carry pain from facet joints in the neck or back. It is usually offered after diagnostic blocks confirm that the facet joint is the pain source.

Why it is done

Indications include chronic back or neck pain from facet joints that has not responded to conservative care, confirmed by two positive diagnostic blocks.

How to prepare

Blood thinners are reviewed (they may be paused). Tell the team about pacemakers (radiofrequency can interfere) and allergies. No fasting unless sedation is planned. MRI and prior block results guide the target levels.

What happens during the procedure

Under X-ray guidance with local anaesthetic (sometimes light sedation), needles are placed at the medial branch nerves; a test stimulation checks position, then the radiofrequency current heats the tip to create a small heat lesion. Each level takes about 15 minutes; several levels may be treated in one session.

Afterwards — recovery & results

You go home the same day, usually with an escort if sedated. Soreness at the needle sites for a few days is common. Benefit begins over one to three weeks as the nerve effect sets in, lasting months (often 6 to 12 months) as nerves regrow.

Risks & considerations

Risks include bleeding, infection, increased pain temporarily, and numbness or weakness (uncommon at these tiny sensory nerves). Repeating the procedure is possible when pain returns after a good response.

Frequently asked questions

Why the diagnostic blocks first?

Facet pain has no reliable scan sign; the blocks test whether numbing the nerve removes your pain. Without them, RFA is a gamble — with them, success rates are much better.

Does it damage the spine?

No — the heat affects only the tiny sensory nerve branches, not the spine's structure. The main nerve root is carefully avoided during placement.

Related procedures — Minor Procedures, Injections & Pain Relief

Acupuncture and dry needling (clinical context)Botox for chronic migraineCasting and splinting for fracturesCryotherapy for skin lesions (seborrheic keratoses, actinic keratoses)Ear grommet insertion (myringotomy with tubes)Ear wax removal (microsuction / irrigation)

Browse the R section of the A–Z list or return to the Procedures & Tests hub.

Please note: This page is educational information about a medical procedure or test. It does not replace the instructions of your own care team, who know your situation and whose preparation, fasting and medication advice you should follow if it differs from anything here. If you have symptoms that worry you, or an appointment you do not understand, contact your clinical team.